Cerebral microglial activation in patients with hepatitis c: In vivo evidence of neuroinflammation

V. P.B. Grover, N. Pavese, Seong Beom Koh, M. Wylezinska, B. K. Saxby, A. Gerhard, D. M. Forton, D. J. Brooks, H. C. Thomas, S. D. Taylor-Robinson

Research output: Contribution to journalArticle

88 Citations (Scopus)

Abstract

Patients with chronic hepatitis C infection may exhibit neuropsychological symptoms and cognitive impairment. Post-mortem studies of hepatitis C virus HCV quasispecies and replicative intermediates indicate that the brain might act as a separate compartment for viral replication and microglia may be the locus for infection and subsequent neuroinflammatory activity. We sought to use two independent in vivo imaging techniques to determine evidence of neuroinflammation in patients with histologically mild chronic hepatitis C. Using positron emission tomography (PET) with a ligand for microglial/brain macrophage activation, 11C-(R)-PK11195 (PK11195) and cerebral proton magnetic resonance spectroscopy, we determined whether there was evidence of neuroinflammation in a pilot study of 11 patients with biopsy-proven mild chronic hepatitis C, compared to healthy volunteers. Patients were characterized by cognitive testing and the fatigue impact scale to assess for CNS impairment. PK11195 binding potential was significantly increased in the caudate nucleus of patients, compared to normal controls (P = 0.03). The caudate and thalamic binding potential were more significantly increased in six patients with genotype 1 infection (P = 0.007) and positively correlated with viraemia (r = 0.77, P = 0.005). Basal ganglia myo-inositol/creatine and choline/creatine ratios were also significantly elevated in patients with chronic hepatitis C compared to normal controls (P = 0.0004 and P = 0.01, respectively). Using PET, we demonstrated evidence of microglial activation, which positively correlated with HCV viraemia and altered cerebral metabolism in the brains of patients with mild hepatitis C. This provides further in vivo evidence for a neurotropic role for HCV.

Original languageEnglish
JournalJournal of Viral Hepatitis
Volume19
Issue number2
DOIs
Publication statusPublished - 2012 Feb 1

Fingerprint

Hepatitis
Chronic Hepatitis C
Creatine
Viremia
Positron-Emission Tomography
Brain
Infection
Macrophage Activation
Caudate Nucleus
Microglia
Inositol
Hepatitis C
Choline
Basal Ganglia
Hepacivirus
Fatigue
Healthy Volunteers
Genotype
Ligands
Biopsy

Keywords

  • cognitive function
  • hepatitis C
  • magnetic resonance spectroscopy
  • positron emission tomography

ASJC Scopus subject areas

  • Hepatology
  • Infectious Diseases
  • Virology

Cite this

Cerebral microglial activation in patients with hepatitis c : In vivo evidence of neuroinflammation. / Grover, V. P.B.; Pavese, N.; Koh, Seong Beom; Wylezinska, M.; Saxby, B. K.; Gerhard, A.; Forton, D. M.; Brooks, D. J.; Thomas, H. C.; Taylor-Robinson, S. D.

In: Journal of Viral Hepatitis, Vol. 19, No. 2, 01.02.2012.

Research output: Contribution to journalArticle

Grover, VPB, Pavese, N, Koh, SB, Wylezinska, M, Saxby, BK, Gerhard, A, Forton, DM, Brooks, DJ, Thomas, HC & Taylor-Robinson, SD 2012, 'Cerebral microglial activation in patients with hepatitis c: In vivo evidence of neuroinflammation', Journal of Viral Hepatitis, vol. 19, no. 2. https://doi.org/10.1111/j.1365-2893.2011.01510.x
Grover, V. P.B. ; Pavese, N. ; Koh, Seong Beom ; Wylezinska, M. ; Saxby, B. K. ; Gerhard, A. ; Forton, D. M. ; Brooks, D. J. ; Thomas, H. C. ; Taylor-Robinson, S. D. / Cerebral microglial activation in patients with hepatitis c : In vivo evidence of neuroinflammation. In: Journal of Viral Hepatitis. 2012 ; Vol. 19, No. 2.
@article{b3ec9f3f31294948a7f15eb531a5e0b0,
title = "Cerebral microglial activation in patients with hepatitis c: In vivo evidence of neuroinflammation",
abstract = "Patients with chronic hepatitis C infection may exhibit neuropsychological symptoms and cognitive impairment. Post-mortem studies of hepatitis C virus HCV quasispecies and replicative intermediates indicate that the brain might act as a separate compartment for viral replication and microglia may be the locus for infection and subsequent neuroinflammatory activity. We sought to use two independent in vivo imaging techniques to determine evidence of neuroinflammation in patients with histologically mild chronic hepatitis C. Using positron emission tomography (PET) with a ligand for microglial/brain macrophage activation, 11C-(R)-PK11195 (PK11195) and cerebral proton magnetic resonance spectroscopy, we determined whether there was evidence of neuroinflammation in a pilot study of 11 patients with biopsy-proven mild chronic hepatitis C, compared to healthy volunteers. Patients were characterized by cognitive testing and the fatigue impact scale to assess for CNS impairment. PK11195 binding potential was significantly increased in the caudate nucleus of patients, compared to normal controls (P = 0.03). The caudate and thalamic binding potential were more significantly increased in six patients with genotype 1 infection (P = 0.007) and positively correlated with viraemia (r = 0.77, P = 0.005). Basal ganglia myo-inositol/creatine and choline/creatine ratios were also significantly elevated in patients with chronic hepatitis C compared to normal controls (P = 0.0004 and P = 0.01, respectively). Using PET, we demonstrated evidence of microglial activation, which positively correlated with HCV viraemia and altered cerebral metabolism in the brains of patients with mild hepatitis C. This provides further in vivo evidence for a neurotropic role for HCV.",
keywords = "cognitive function, hepatitis C, magnetic resonance spectroscopy, positron emission tomography",
author = "Grover, {V. P.B.} and N. Pavese and Koh, {Seong Beom} and M. Wylezinska and Saxby, {B. K.} and A. Gerhard and Forton, {D. M.} and Brooks, {D. J.} and Thomas, {H. C.} and Taylor-Robinson, {S. D.}",
year = "2012",
month = "2",
day = "1",
doi = "10.1111/j.1365-2893.2011.01510.x",
language = "English",
volume = "19",
journal = "Journal of Viral Hepatitis",
issn = "1352-0504",
publisher = "Wiley-Blackwell",
number = "2",

}

TY - JOUR

T1 - Cerebral microglial activation in patients with hepatitis c

T2 - In vivo evidence of neuroinflammation

AU - Grover, V. P.B.

AU - Pavese, N.

AU - Koh, Seong Beom

AU - Wylezinska, M.

AU - Saxby, B. K.

AU - Gerhard, A.

AU - Forton, D. M.

AU - Brooks, D. J.

AU - Thomas, H. C.

AU - Taylor-Robinson, S. D.

PY - 2012/2/1

Y1 - 2012/2/1

N2 - Patients with chronic hepatitis C infection may exhibit neuropsychological symptoms and cognitive impairment. Post-mortem studies of hepatitis C virus HCV quasispecies and replicative intermediates indicate that the brain might act as a separate compartment for viral replication and microglia may be the locus for infection and subsequent neuroinflammatory activity. We sought to use two independent in vivo imaging techniques to determine evidence of neuroinflammation in patients with histologically mild chronic hepatitis C. Using positron emission tomography (PET) with a ligand for microglial/brain macrophage activation, 11C-(R)-PK11195 (PK11195) and cerebral proton magnetic resonance spectroscopy, we determined whether there was evidence of neuroinflammation in a pilot study of 11 patients with biopsy-proven mild chronic hepatitis C, compared to healthy volunteers. Patients were characterized by cognitive testing and the fatigue impact scale to assess for CNS impairment. PK11195 binding potential was significantly increased in the caudate nucleus of patients, compared to normal controls (P = 0.03). The caudate and thalamic binding potential were more significantly increased in six patients with genotype 1 infection (P = 0.007) and positively correlated with viraemia (r = 0.77, P = 0.005). Basal ganglia myo-inositol/creatine and choline/creatine ratios were also significantly elevated in patients with chronic hepatitis C compared to normal controls (P = 0.0004 and P = 0.01, respectively). Using PET, we demonstrated evidence of microglial activation, which positively correlated with HCV viraemia and altered cerebral metabolism in the brains of patients with mild hepatitis C. This provides further in vivo evidence for a neurotropic role for HCV.

AB - Patients with chronic hepatitis C infection may exhibit neuropsychological symptoms and cognitive impairment. Post-mortem studies of hepatitis C virus HCV quasispecies and replicative intermediates indicate that the brain might act as a separate compartment for viral replication and microglia may be the locus for infection and subsequent neuroinflammatory activity. We sought to use two independent in vivo imaging techniques to determine evidence of neuroinflammation in patients with histologically mild chronic hepatitis C. Using positron emission tomography (PET) with a ligand for microglial/brain macrophage activation, 11C-(R)-PK11195 (PK11195) and cerebral proton magnetic resonance spectroscopy, we determined whether there was evidence of neuroinflammation in a pilot study of 11 patients with biopsy-proven mild chronic hepatitis C, compared to healthy volunteers. Patients were characterized by cognitive testing and the fatigue impact scale to assess for CNS impairment. PK11195 binding potential was significantly increased in the caudate nucleus of patients, compared to normal controls (P = 0.03). The caudate and thalamic binding potential were more significantly increased in six patients with genotype 1 infection (P = 0.007) and positively correlated with viraemia (r = 0.77, P = 0.005). Basal ganglia myo-inositol/creatine and choline/creatine ratios were also significantly elevated in patients with chronic hepatitis C compared to normal controls (P = 0.0004 and P = 0.01, respectively). Using PET, we demonstrated evidence of microglial activation, which positively correlated with HCV viraemia and altered cerebral metabolism in the brains of patients with mild hepatitis C. This provides further in vivo evidence for a neurotropic role for HCV.

KW - cognitive function

KW - hepatitis C

KW - magnetic resonance spectroscopy

KW - positron emission tomography

UR - http://www.scopus.com/inward/record.url?scp=84855852639&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84855852639&partnerID=8YFLogxK

U2 - 10.1111/j.1365-2893.2011.01510.x

DO - 10.1111/j.1365-2893.2011.01510.x

M3 - Article

C2 - 22239531

AN - SCOPUS:84855852639

VL - 19

JO - Journal of Viral Hepatitis

JF - Journal of Viral Hepatitis

SN - 1352-0504

IS - 2

ER -